CAPITAL CLUBHOUSE BOARD MEMBER TESTIFIES BEFORE DC COUNCIL

Capital Clubhouse Board Member Yvonne Smith

Good morning Chairman Gray and members of the Committee on Health. My name is Yvonne Smith, a resident of Ward 8 and a Board member of Capital Clubhouse, Inc., a non profit organization dedicated to providing persons living with mental illness with opportunities for employment, education, vocational training, and access to behavioral and other health services in a structured, caring, and peer-oriented environment based on a work-ordered day. We aim to help those persons recover and fully participate as valued members of the D.C. community.

As brief background, the first clubhouse, Fountain House, was started in New York in 1948. Today, there are over 320 clubhouses worldwide and over 200 clubhouses in more than half of the states in the U.S. These clubhouses offer evidence-based services that have been found to lower hospital re-admissions, reduce health expenditures, assist members in getting back to work, and improve overall recovery. Despite the prevalence of clubhouses and their value, D.C. has had no operating clubhouse for 7 years. This gap is significant given the city’s high unmet need for behavioral health services. We plan to fill this void when we open, operating in accordance with the Clubhouse International clubhouse accreditation standards. However, our opening is contingent upon a change in DBH’s regulations which, as presently drafted, in fact impede the opening of a new Clubhouse in the District of Columbia.

Capital Clubhouse testified before this Committee last year regarding our plans to begin offering these vital services to D.C. residents and our need for a stronger partnership with DBH in order to open. Since last year’s testimony, our dialogue with DBH has improved. Our Board has also been moving forward, operating under the assumption that DBH will act to enable Capital Clubhouse to open, and we are now prepared to begin offering services in mid-2018. Last August, we hired an Executive Director, who will guide the day-to-day operations of the Clubhouse. She has met with several organizations who are eager to begin referring members to Capital Clubhouse and we are actively seeking our headquarters space. We held a successful fundraiser gala in late 2017 and were delighted to host, over 150 persons dedicated to addressing behavioral health in DC. This was our fourth annual fundraiser and we now have the financial resources to open. We do need, however, to show results or these donations will dry up.

In order to open our doors in D.C., we will need both the continued support of and action from the Department of Behavioral Health. Since our testimony last year, we note a deepened engagement, with regular, thoughtful meetings with Jim Wotring and others from the Department regarding the regulatory changes that must be made in order for any clubhouse to be able to open in Washington, D.C. We are very grateful to Jim Wotring, Atiya Frame, Christine Phillips, Marina Soto, and others in the Department for their support over this past year. Yet, we will need action from the Department over the next several months as we launch our programming. Specifically, we must resolve the two sets of regulatory and Medicaid financing issues that we have been discussing with DBH over the past five years in order to allow us to get up and running.

First, D.C.’s existing regulations regarding clubhouses were drafted to pertain to a particular non profit organization that closed over seven years agobut now preclude a new Clubhouse from opening. The current regulations require that a clubhouse already exist in a fully-accredited form before it can be recognized as a clubhouse. Clubhouse International, however, requires that a clubhouse be open and operating, under its oversight, as it works towards achieving the milestones required for full accreditation. This is impossible under the current regulations. As the Department is aware, if these regulations are not amended, they will prevent any new clubhouse from opening its doors in D.C. We have discussed these issues and other problems with the existing regulations with the Department and mapped out a framework for regulatory amendments that would allow clubhouses to open and serve DC residents, while ensuring that they meet rigorous, high-quality standards. Given our anticipated summer 2018 opening, we need DBH to finalize these regulatory amendments and put them through notice and comment rulemaking in the very near future. Otherwise, we will need to consider alternatives, including the potential reality of continuing to have no clubhouse in D.C. for the foreseeable future despite the city’s urgent need for such services, as we are incurring expenses and our financial resources, donated largely by individuals, are not unlimited.

Second, we expect to serve Medicaid beneficiaries as some of our clubhouse members will depend upon public funding to supplement the generous private donations we receive. We hope to partner with the Department to streamline the City’s requirements for providing Medicaid financing for clubhouse services – following in the footsteps of several other states, such as Michigan, that have recently made such changes.

We greatly appreciate the support that the Department has provided to us thus far. And we look forward to resolving these outstanding issues. We request that the Council encourage the Department to help us resolve these issues in a timely manner in the next several months so that we can open our doors in DC in 2018, as planned.​Finally, as a member of the DC Behavioral Health Association, we would also like to echo the points that the Association raised in its testimony. As Capital Clubhouse becomes operational, we too will confront these issues and they will need to be addressed to ensure we can operate on a stable footing within the Department’s financing guidelines.